| Introduction
In 1994, Anne
told me that she was admitted to a mental hospital
as a school girl. She was often medicated with
a major psychotropic drug, Mellaril, and was also
administered Electroconvulsive Therapy. This affected
her memory and her education. She became a chronic
psychiatric casualty who is still chemically dependent
today. Her sister was placed in a Welfare institution
and was subjected to harsh treatment from big
girls of a different sexual orientation. Anne
was raped in the mental hospital while her sister
was bashed in the Welfare institution.
Many people have
lived a life of chronic disadvantage arising from
the system taking over and breaking families irreparably.
In the fifties, sixties and seventies there was
not much knowledge of the consequences and deep
injuries done to members of dysfunctional families.
Families that were cut adrift by the system had
children and adolescents sent to foster homes,
institutions or to mental hospitals. Sexual abuse
occurred, probably frequently. One former female
foster child told me in 1994 that she had been
sexually abused in foster care. Two men, Adrian
and Peter recently told me they had similar experiences
in foster care.
Members of dysfunctional
families have always been of interest to Welfare
and Psychiatry. What is becoming apparent is that
many of their issues are social problems that
create burdens on the taxpayer, benefit dependency,
and much ill health in the face of health fund
cuts. Health cuts now ensure that only clearly
diagnosed people and substance abusers are treated
or hospitalized. The social problems now have
to be worked out with people who are not interested,
and often not knowledgeable about the issues.
One way to address social and family dysfunction
is through education - self-education for survivors
and also for the professional people who assist
survivors.
Some survivors,
for example, may experience repeated abuse, isolation
and witness threatening and intimidating behavior
of others. Oftentimes, other family members' inappropriate
behavior or reactions (e.g., they blame the survivor
for the abuse) heightens traumatic reactions.
The survivor may (if they are lucky) be referred
for professional help. The casualties of families
like this have been described in submissions to
the 1996 Mental Health Inquiry. In the meantime,
with limited resources, some psychiatric and/or
mental health professionals will send the victims
away and say "Go back to your family."
There may be no family to return to! This is a
social problem and there are too many casualties
in New Zealand with issues still not properly
resolved.
In the early 1990s,
I addressed Social Workers of the Children and
Young Persons Service. I told them that I often
speculated over whether or not some foster children
were being abused by their foster parents. A Social
Worker gave me vigorous nods from a back seat.
Children of abusive parents may be affected by
family dysfunction from the extended family that
became their foster family. As adults, they are
prone to becoming ill and have more brushes with
"the system." In many cases their sense
of self worth may be severely knocked, and there
are few reliable supportive people in their environment.
Every survivor
has good attributes and qualities. They may have
tremendous potential but in difficult financial
times, survivors often do not have the money to
develop that potential. An adjunct Professor in
Colorado, Dr. Warner wrote that survivors of Schizophrenia
could recover in prosperous times. The same is
true of every other survivor in New Zealand.
In 1994, a Social
Worker with Children and Young Persons Service
suggested to me that long-term consequences of
family dysfunction were not the problem of their
department. An Income Support person told me both
branches kept on "passing the buck."
In 1995, I suggested to policy makers that they
bring parents into the campaign on prevention
of child abuse. The reply was that it "all
depended upon the allocation of resources."
In 1998, the Children
and Young Persons Service are now pushing to collaborate
with Health personnel. Public Health and the Children
and Young Persons Service in New Zealand are affected
by funding cuts. So problems of dysfunction affect
family members responsible for people who have
gone through the system. Other victims are left
to their own devices, often in conditions of chronic
disadvantage and extreme poverty.
Posttraumatic
Stress Disorder
More knowledge
has emerged since the eighties in keeping with
the policy of emptying the mental hospitals; it
was then that Posttraumatic Stress Disorder (PTSD)
entered the diagnostic manual. This is a useful
way to understand the effects described above.
A significant and deleterious aspect of PTSD is
the train of thoughts associated with the violence
experienced by survivors at the hands of abusive
or hostile people. The traumatic thoughts may
haunt the sufferers for two decades or more. The
thoughts can also be accompanied by vivid pictures
behind the eyes of violent or vicious people.
These pictures are called "flashbacks."
Some sufferers never lose their traumatic thoughts
or the flashbacks. Pharmacology may aid in diminishing
certain symptoms, but there is still sound evidence
that mental health professionals often make serious
diagnostic errors regarding PTSD. Survivors of
PTSD may be misdiagnosed as Borderline Personality
Disorder and may be pressured to change their
behavior.
Some survivors,
unable to stop the flashbacks, may create different
pictures. Some may become sufficiently empowered
to understand that flashbacks are a symptom of
Posttraumatic Stress Disorder and effectively
reduce or stop them all together. Toxic psychiatry
or ill-prescribed drugs may exacerbate trauma
reactions and at times, contribute toward the
experience of flashbacks.
Flashbacks can
cause terror and horror for survivors. It is comparable
with (and often confused with) the hallucinations
of Schizophrenia. Many women affected by PTSD
died at the hands of their violent spouses before
laws changed in the United States. Aphrodite Matsakis,
Ph.D. a specialist in PTSD wrote about "Claudia"
in Chapter Four of her book I Can't Get Over
It. Claudia was a battered wife to whom the
police said "There's nothing we can do about
it. Call us after he actually starts beating or
cutting you." In the United States in the
1960s, a wife needed consistent hospital reports
for seven years before she could win divorce on
"battered wife" grounds and a fair settlement.
Claudia did not win her divorce, her spouse did.
Evidence was given at the court that she had several
(unspecified) psychiatric disorders. She was blamed
for breaking up a happy home. Her spouse won the
home and left her in poverty. His victory gave
him authority to tell Claudia that he would get
the children if she could not support them. Dr.
Matsakis wondered whether Claudia's legal counsel
was incompetent, or whether there were darker
reasons that the personality of the abusive spouse
was not brought up in the divorce proceedings.
Dr. Matsakis writes
that professionals including doctors and nurses,
at times, minimize grievous losses. For example,
after a Hurricane, a concert violinist was taken
to a makeshift hospital along with others who
were injured. When she was told that three of
her fingers would have to be amputated, she began
to cry. Her nurse told her "Hush now, you
big crybaby, bed number one lost his arm and bed
two has to have both legs removed. Count your
blessings and don't upset the others." It
is this sort of indifference that must stop. If
more people including professionals hear the cries,
I believe that many of the tragedies (and potentially,
revictimization) could be stopped by a change
in direction from the policy makers.
Emotional
Disorders and Denial
New Zealand has
been in denial of the realities of social disadvantage
for many years. The denial is possibly an artifact
of people being frightened by what they can not
face in themselves. Victims of social casualties,
injustices, and massive losses are prevalent in
New Zealand society and survivors can and will
not go away.
One abused woman
was told by her divorced spouse that she could
"crawl off the face off the earth."
This is indicative of the way many people regard
abused people, who need to be heard and be assured
that the injustices will be addressed. If society,
social policy makers and the lawmakers do listen,
the pain may be slightly alleviated. Unfortunately,
many adhere to a "Just World" philosophy
(see the work of Janoff-Bulman). The basic assumption
of the "Just World" philosophy is that
if you are sufficiently careful, intelligent,
moral, or competent, you can avoid misfortune.
A Case
Example from Aotearoa, New Zealand
New Moon,
a newsletter put out by the Aotearoa Network of
Psychiatric Survivors, published an account in
1992 of a woman, "Raelene," not being
dealt with appropriately or compassionately after
she was raped by an Island man in a mental hospital.
She was later cruelly manhandled by nurses when
she spoke about the rape at a group meeting. The
hospital people told the family an alleged incident
occurred. I met Raelene in 1994. She was repeatedly
committed through the testimony of a nurse solely
concerned with the behavior and the symptoms.
Raelene was trying to restore the lost mobility
of her left side. She had to have several smaller
meals in the course of a day because of her stomach
condition. Her stomach bled from the drugs she
was made to take and the last time I saw her,
she looked very ill indeed.
Deinstitutionalization:
Human Rights or Financially Driven?
A few years ago,
a nurse asked me what I thought was the driving
force behind the emptying of the mental hospitals.
I believe that the policy is driven monetarily.
Dr. Jenkins, a United Kingdom doctor, attended
the 1993 mental health conference in Auckland.
He suggested that the proceeds from the sales
of hospitals should be put back into providing
services. This would ensure that deinstitutionalization
would be successful. Unfortunately, proceeds of
the sales of hospitals do not appear to have been
injected into community services.
Conclusion
Although more
care with psychiatric and abuse survivors is often
taken today, not all cases are successfully helped.
My research and experience in the first half of
this decade appears to be about abused
rather than mentally ill people, per se. Survivors'
family status is not always addressed by support
workers, although family status in the Human Rights
legislation must be adhered to. The Human Rights
Act covers situations such as employment, provision
of services, and accommodations on the grounds
of age, sexual status, health and family status.
Survivors are
often held accountable for the wrongdoing in their
family. We must remember that the problems of
sexual abuse in children, adolescents and adults
as well as the abuse sustained by the members
of dysfunctional families are very serious. Theses
difficulties are quite prevalent. The issues often
appear to be swept under the carpet. Sadly, misdiagnosed
survivors are often ridiculed or stigmatized by
many people which perpetuates their social disadvantage.
©1998
by The American Academy of Experts in Traumatic
Stress, Inc. |
